Research Article
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Yaşlı Hastalarda Uygunsuz İlaç Kullanımının İncelenmesi ve Polifarmasi Varlığı

Year 2019, , 1254 - 1266, 15.04.2019
https://doi.org/10.30569/adiyamansaglik.513045

Abstract

Amaç: Bu çalışmamızda 65
yaş ve üzeri yatan hastalarda hem uygunsuz ilaç kullanımının ve polifarmasi
varlığının araştırılması ve hem de bu uygunsuz durumların hastaların hastanede
kalış sürelerine olan etkisi incelenmiştir.

Yöntem: Çalışmamızın kaynağını oluşturan veriler, Ocak-Mart 2016 tarihleri
arasında Adıyaman Üniversitesi Eğitim ve Araştırma Hastanesine başvuran 65 yaş
ve üzeri 970 hastadan örneklem yoluyla seçilen hasta dosyalarının retrospektif
olarak incelenmesi sonucu elde edildi. Uygunsuz ilaç kullanımının tespiti
Avrupa Birliği (EU) listesi (EU7-PIM list) kullanılarak yapıldı.

Bulgular:
Çalışmamıza
katılan hastalardaki uygunsuz ilaç varlığına bakıldığında hastaların %59.4’ünde
yani 77 adedinde uygunsuz ilaç varlığı tespit edildi. Bu ilaçlar arasında
“teofilin” %33.3 oranla en fazla kullanılan uygunsuz ilaç olduğu görüldü.







Sonuç: Yaşlı hastalarda tedavi protokolü belirlenmeden önce hastada geniş bir
geriatrik değerlendirme yapılması, kullanılacak ilaçların endikasyon uyumuna
bakılması, hastanın sürekli kullandığı ilaçların dikkate alınarak yeni ilaçlara
başlanması gerekmektedir. 

References

  • 1. Gulhan R. Rational Drug Use in Elderly. Med J Okmeydani Train Res Hosp. 2014;29(Supplement 2):99–105.
  • 2. Kahveci R. Hastanede Yatan Ya ş lı Hastalarda Uygunsuz İ laç Kullanımı Inappropriate Drug Use in Hospitalized Elderly Patients. 2015;117–25.
  • 3. Fak STIP, Anab H, Tez U, Dan T. Yaşlılarda Uygunsuz İlaç Kullanımının 2012 Beers Kriterleri ve Stopp Versiyon 2 Kriterleri ile Değerlendirilmesi. 2015;
  • 4. KİTİŞ Y, TERZİ H. The Beers Criteria: A Guide for the Prevention of Inappropriate Drug Utilization in the Elderly Individuals: Review. Turkiye Klin J Nurs. 2016;8(2):162–75.
  • 5. Kerry Z. Yaşlılarda doğru ilaç kullanımı Rational drug use in elderly. 2015;62–73.
  • 6. Ya ZET. Ayşe Gelal PHARMACODYNAMIC CHANGES AFFECTING DRUG USE IN ELDERLY. 2006;(232):33–6.
  • 7. Yeşİl Y, Cankurtaran M, Kuyumcu ME, Fakültesi HT, Hastalıları İ, Dalı A, et al. Giriş ve Tanım. 2007;
  • 8. Bahat G, Tufan F, Bahat Z, Aydin Y, Tufan A, Akpinar TS, et al. Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly. Aging Male. 2013;16(2):67–72.
  • 9. Gökçe-Kutsal Y. Yaşlılarda Çoklu İlaç Kullanımı. Turkish J Geriatr. 2006;Özel Sayı(312):37–44. 10. Elderly and Rational Drug Use - Ya ş l ı ve Ak ı lc ı İ laç Kullan ı m ı Yaşlı ve Akılcı İlaç Kullanımı. 2016;(APRIL 2015).
  • 11. Tunca M. Ya??lilarda ila?? etkile??imleri ve klinik ??nemi. Turk Geriatr Derg. 2006;9(SUPPL.):45–8.
  • 12. Adverse Drug Events Frequently Encountered in Elderly. 2006;2006(232):49–52.
  • 13. Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: A list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71(7):861–75.
  • 14. Arslan Ş. Ya ş lilarda i̇ laç tüket i̇ m i̇. 2000;3(2):56–60.
  • 15. Akıcı A. Akılcı ilaç kullanımı ilkeleri doğrultusunda yaşlılarda reçete yazma ve Türkiye’de yaşlılarda ilaç kullanımının boyutları. Geriatr Özel Sayı. 2006;19–27. 17. Taşkın Şayir Ç. Evaluation of polypharmacy and complementary therapy use in patients >=65 years, attending to Family Medicine Outpatient Clinic of Şişli Etfal Training and Research Hospital. Turkiye Aile Hekim Derg. 2014;18(1):35–41.
  • 18. Jacob L, Breuer J, Kostev K. Prevalence of chronic diseases among older patients in German general practices. GMS Ger Med Sci. 2016;14:1–7.
  • 19. Cankara FN, Aşcı H, Sönmez Y. Bir üniversite hastanesinde yatan hastalarda hekimlerin ilaç tercihleri ve polifarmasi varlığı Physicians ’ drug preferences and polypharmacy presence in inpatients of university hospital. 2015;1–6.
  • 20. Lee D, Martini N, Moyes S, Hayman K, Zolezzi M, Kerse N. Potentially inappropriate medication use: The Beers’ Criteria used among older adults with depressive symptoms. J Prim Health Care. 2013;5(3):182–90.
  • 21. Urbanek K, Kristova ÆV. Polypharmacy in elderly hospitalised patients in Slovakia. 2008;235–42.
  • 22. Onder G, Liperoti R, Fialova D, Topinkova E, Tosato M, Danese P, et al. Polypharmacy in Nursing Home in Europe : Results From the SHELTER Study. 2018;(May):698–704.
  • 23. Schumm P, Lindau ST. NIH Public Access. 2009;300(24):2867–78.
  • 24. Gutiérrez-Valencia M, Izquierdo M, Malafarina V, Alonso-Renedo J, González-Glaría B, Larrayoz-Sola B, et al. Impact of hospitalization in an acute geriatric unit on polypharmacy and potentially inappropriate prescriptions: A retrospective study. Geriatr Gerontol Int. 2017;17(12):2354–60.
  • 25. Wauters M, Elseviers M, Azermai M, Vander Stichele R. Availability and actual use in the Belgian market of potentially inappropriate medications (PIMs) from the EU(7)-PIM list. Eur J Clin Pharmacol. 2016;72(2):243–5.
  • 26. Mucalo I, Hadžiabdić MO, Brajković A, Lukić S, Marić P, Marinović I, et al. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. Eur J Clin Pharmacol. 2017;73(8):991–9.
  • 27. Grina D, Briedis V. The use of potentially inappropriate medications among the Lithuanian elderly according to Beers and EU(7)-PIM list – a nationwide cross-sectional study on reimbursement claims data. J Clin Pharm Ther. 2017;42(2):195–200.
  • 28. Sönnerstam E, Sjölander M, Gustafsson M. An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list. Eur J Clin Pharmacol. European Journal of Clinical Pharmacology; 2017;73(6):735–42.
  • 29. Novaes PH, da Cruz DT, Lucchetti ALG, Leite ICG, Lucchetti G. Comparison of four criteria for potentially inappropriate medications in Brazilian community-dwelling older adults. Geriatr Gerontol Int. 2017;17(10):1628–35.
  • 30. Park JW, Roh JL, Lee S wook, Kim SB, Choi SH, Nam SY, et al. Effect of polypharmacy and potentially inappropriate medications on treatment and posttreatment courses in elderly patients with head and neck cancer. J Cancer Res Clin Oncol. Springer Berlin Heidelberg; 2016;142(5):1031–40.

Investigation of Inappropriate Drug Use in Older Patients and Polifarmacy Presence

Year 2019, , 1254 - 1266, 15.04.2019
https://doi.org/10.30569/adiyamansaglik.513045

Abstract

Aim: In this study, we investigated the presence of
inappropriate drug use and polypharmacy in patients aged 65 years and over and
the effect of these inappropriate conditions on the duration of hospital stay.

Method: The data of our study were obtained by
retrospectively examining the patient files selected through sampling from 970
patients aged 65 years and older who applied to Adıyaman University Training
and Research Hospital between January and March 2016. Detection of
inappropriate drug use was made using the EU list (EU7-PIM list).

Results: In our study, the presence of
inappropriate drug in the patients who participated in the study was found in
59.4% of the patients in 77 of the drug was found to be inappropriate. Among
these drugs, suz theophylline fazla was the most commonly used inappropriate
drug with a rate of 33.3%.







Conclusion: It is necessary to perform a large
geriatric evaluation in the patient before the treatment protocol is determined
in elderly patients, to look for the indication compliance of the drugs to be
used, and to start new drugs taking into account the drugs used by the patient
continuously.

References

  • 1. Gulhan R. Rational Drug Use in Elderly. Med J Okmeydani Train Res Hosp. 2014;29(Supplement 2):99–105.
  • 2. Kahveci R. Hastanede Yatan Ya ş lı Hastalarda Uygunsuz İ laç Kullanımı Inappropriate Drug Use in Hospitalized Elderly Patients. 2015;117–25.
  • 3. Fak STIP, Anab H, Tez U, Dan T. Yaşlılarda Uygunsuz İlaç Kullanımının 2012 Beers Kriterleri ve Stopp Versiyon 2 Kriterleri ile Değerlendirilmesi. 2015;
  • 4. KİTİŞ Y, TERZİ H. The Beers Criteria: A Guide for the Prevention of Inappropriate Drug Utilization in the Elderly Individuals: Review. Turkiye Klin J Nurs. 2016;8(2):162–75.
  • 5. Kerry Z. Yaşlılarda doğru ilaç kullanımı Rational drug use in elderly. 2015;62–73.
  • 6. Ya ZET. Ayşe Gelal PHARMACODYNAMIC CHANGES AFFECTING DRUG USE IN ELDERLY. 2006;(232):33–6.
  • 7. Yeşİl Y, Cankurtaran M, Kuyumcu ME, Fakültesi HT, Hastalıları İ, Dalı A, et al. Giriş ve Tanım. 2007;
  • 8. Bahat G, Tufan F, Bahat Z, Aydin Y, Tufan A, Akpinar TS, et al. Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly. Aging Male. 2013;16(2):67–72.
  • 9. Gökçe-Kutsal Y. Yaşlılarda Çoklu İlaç Kullanımı. Turkish J Geriatr. 2006;Özel Sayı(312):37–44. 10. Elderly and Rational Drug Use - Ya ş l ı ve Ak ı lc ı İ laç Kullan ı m ı Yaşlı ve Akılcı İlaç Kullanımı. 2016;(APRIL 2015).
  • 11. Tunca M. Ya??lilarda ila?? etkile??imleri ve klinik ??nemi. Turk Geriatr Derg. 2006;9(SUPPL.):45–8.
  • 12. Adverse Drug Events Frequently Encountered in Elderly. 2006;2006(232):49–52.
  • 13. Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: A list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71(7):861–75.
  • 14. Arslan Ş. Ya ş lilarda i̇ laç tüket i̇ m i̇. 2000;3(2):56–60.
  • 15. Akıcı A. Akılcı ilaç kullanımı ilkeleri doğrultusunda yaşlılarda reçete yazma ve Türkiye’de yaşlılarda ilaç kullanımının boyutları. Geriatr Özel Sayı. 2006;19–27. 17. Taşkın Şayir Ç. Evaluation of polypharmacy and complementary therapy use in patients >=65 years, attending to Family Medicine Outpatient Clinic of Şişli Etfal Training and Research Hospital. Turkiye Aile Hekim Derg. 2014;18(1):35–41.
  • 18. Jacob L, Breuer J, Kostev K. Prevalence of chronic diseases among older patients in German general practices. GMS Ger Med Sci. 2016;14:1–7.
  • 19. Cankara FN, Aşcı H, Sönmez Y. Bir üniversite hastanesinde yatan hastalarda hekimlerin ilaç tercihleri ve polifarmasi varlığı Physicians ’ drug preferences and polypharmacy presence in inpatients of university hospital. 2015;1–6.
  • 20. Lee D, Martini N, Moyes S, Hayman K, Zolezzi M, Kerse N. Potentially inappropriate medication use: The Beers’ Criteria used among older adults with depressive symptoms. J Prim Health Care. 2013;5(3):182–90.
  • 21. Urbanek K, Kristova ÆV. Polypharmacy in elderly hospitalised patients in Slovakia. 2008;235–42.
  • 22. Onder G, Liperoti R, Fialova D, Topinkova E, Tosato M, Danese P, et al. Polypharmacy in Nursing Home in Europe : Results From the SHELTER Study. 2018;(May):698–704.
  • 23. Schumm P, Lindau ST. NIH Public Access. 2009;300(24):2867–78.
  • 24. Gutiérrez-Valencia M, Izquierdo M, Malafarina V, Alonso-Renedo J, González-Glaría B, Larrayoz-Sola B, et al. Impact of hospitalization in an acute geriatric unit on polypharmacy and potentially inappropriate prescriptions: A retrospective study. Geriatr Gerontol Int. 2017;17(12):2354–60.
  • 25. Wauters M, Elseviers M, Azermai M, Vander Stichele R. Availability and actual use in the Belgian market of potentially inappropriate medications (PIMs) from the EU(7)-PIM list. Eur J Clin Pharmacol. 2016;72(2):243–5.
  • 26. Mucalo I, Hadžiabdić MO, Brajković A, Lukić S, Marić P, Marinović I, et al. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. Eur J Clin Pharmacol. 2017;73(8):991–9.
  • 27. Grina D, Briedis V. The use of potentially inappropriate medications among the Lithuanian elderly according to Beers and EU(7)-PIM list – a nationwide cross-sectional study on reimbursement claims data. J Clin Pharm Ther. 2017;42(2):195–200.
  • 28. Sönnerstam E, Sjölander M, Gustafsson M. An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list. Eur J Clin Pharmacol. European Journal of Clinical Pharmacology; 2017;73(6):735–42.
  • 29. Novaes PH, da Cruz DT, Lucchetti ALG, Leite ICG, Lucchetti G. Comparison of four criteria for potentially inappropriate medications in Brazilian community-dwelling older adults. Geriatr Gerontol Int. 2017;17(10):1628–35.
  • 30. Park JW, Roh JL, Lee S wook, Kim SB, Choi SH, Nam SY, et al. Effect of polypharmacy and potentially inappropriate medications on treatment and posttreatment courses in elderly patients with head and neck cancer. J Cancer Res Clin Oncol. Springer Berlin Heidelberg; 2016;142(5):1031–40.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Erhan Bozkurt This is me 0000-0002-1853-7098

Ali Parlar This is me 0000-0002-4656-3402

Seyfullah Oktay Arslan 0000-0001-9328-9373

Publication Date April 15, 2019
Submission Date January 15, 2019
Acceptance Date February 19, 2019
Published in Issue Year 2019

Cite

AMA Bozkurt E, Parlar A, Arslan SO. Yaşlı Hastalarda Uygunsuz İlaç Kullanımının İncelenmesi ve Polifarmasi Varlığı. ADYÜ Sağlık Bilimleri Derg. April 2019;5(1):1254-1266. doi:10.30569/adiyamansaglik.513045